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What is the difference of terminology of State and Federal Programs?

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What is the difference of terminology of State and Federal Programs?

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MoDOT can grant a medical exemption only by issuing a Skill Performance Evaluation Certificate (SPE Certificate) to an applicant-driver, pursuant to an application filed with MoDOT Motor Carrier Services. This differs from the federal program for interstate drivers, which issues SPE Certificates only to limb-impaired/amputee drivers, but instead issues “medical exemptions” for drivers with vision impairments or insulin-treated diabetes mellitus (ITDM). MoDOT designates its intrastate medical exemptions as SPE certificates because that term is authorized by Section 622.555 of the Missouri Revised Statutes (RSMo).

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